Study of the Effect of Tamsulosin HCl (an Alpha-1 Receptor Antagonist) as a Medical Expelling Agent on Subsequent Ureteroscopic Procedure for Treatment of Lower Ureteric Stones
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- Category: Vol. 86, September 2018
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Study of the Effect of Tamsulosin HCl (an Alpha-1 Receptor Antagonist) as a Medical Expelling Agent on Subsequent Ureteroscopic Procedure for Treatment of Lower Ureteric Stones, ALI M. GHONEIM, AHMED M. AL-SAKKA, MAGED M. RAGAB and ABD El-HAMID M. EL-BAHNASY
Abstract
Background: Tamsulosin is an a-1A-specific blocker
which induces selective relaxation of ureteral smooth muscle
with subsequent inhibition of ureteral spasms and dilatation
of the ureteral lumen and facilitates stone expulsion.
Aim of the Study: In this prospective randomized study
we aimed to assess the efficacy of use of alpha blocker
(tamsulosin Hcl 0.4mg) on the outecome of ureteroscopic
lithotripsy for distal ureteric stone.
Patients and Methods: In a prospective study by a randomized
controlled clinical trial, which was performed from
September 2016 to March 2017, about 50 patients underwent
ureteroscopic lithotripsy with the pneumatic wolf lithotripsy.
The patients were randomly divided into 2 groups: The study
group including 25 patients, received tamsulosin with our
traditional treatment (hydration and analgesic when required),
and the control group with 25 patients who received placebo
with traditional treatment. Patients prospectively will be
evaluated for stone clearing rate by imaging at morning of
URSL and at the end of 2 nd week including: (KUB and pelvi
abdominal ultrasound)and they will be evaluated for number
of colic episodes, analgesic consumption and post-operative
complications (haematuria and UTI).
Results: The results showed that tamsulosin treatment
group had short time of the procedure, easy extraction of the
stone fragments, had low expulsion time, low urinary tract
symptoms, least analgesic needs and low adverse effects.
Conclusions: Administration of a-1A-specific antagon
istmade the procedure of short time, easy extraction of the
stone fragments reduced analgesic dosage and colic episodes,
rate of adverse effects after ureteroscopic lithotripsy of lower
ureteral stones and decreased gravel expulsion time after
URSL.